
Personalized Outreach Through Phone Visits
Chronic Care Management:
Our approach focuses on personalized care plans, regular monitoring, and routine communication to ensure that patients receive the support they need.
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Coordination/Continuity of Care
The care team will coordinate care among healthcare providers involved in the care, such as primary care physicians, specialists, and other healthcare professionals. This helps avoid fragmented care, reduces unnecessary duplication of services, and addresses any questions/concerns regarding medication.
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Preventative/Proactive Care
The program focuses on addressing concerns and taking immediate steps in preventing complications from chronic conditions through regular monitoring and addressing changes in the health patient’s health status.


Chronic Care Conditions
Care management is beneficial for individuals living with long-term health conditions such as but not limited to;
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Diabetes mellitus
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Heart diseases like coronary artery disease and congestive heart failure
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Chronic obstructive pulmonary disease
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Asthma
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Chronic kidney disease
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Autoimmune diseases, such as rheumatoid arthritis and multiple sclerosis
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Osteoarthritis
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Chronic liver disease (e.g., cirrhosis)
To determine if you are a candidate
or
for more information contact us.